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General NPI Number Information
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NPI Number | 1184714727
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Entity Type | Individual
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Provider Name | ANGEL A LUCIANO MD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 119 OAKFIELD DR
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City | BRANDON
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State | FL
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Zip | 33511-5779
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Country | US
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Telephone | 813-571-5373
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Fax | 727-767-4391
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Provider Business Mailing Address
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Address Line | 2501 N ORANGE AVE STE 446
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City | ORLANDO
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State | FL
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Zip | 32804-4644
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Country | US
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Telephone | 407-303-2528
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME107390
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | ME107390
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License Number State | FL
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